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Suprep

Last reviewed on RxList: 4/11/2018
Suprep Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 4/11/2018

Suprep Bowel Prep Kit (sodium sulfate, potassium sulfate, and magnesium sulfate) Oral Solution is an osmotic laxative indicated for cleansing of the colon in preparation for colonoscopy in adults. Common side effects of Suprep include:

  • overall discomfort,
  • abdominal fullness,
  • nausea,
  • abdominal cramping,
  • vomiting, and
  • headache.

Suprep Bowel Prep Kit is a split dose (2-day) regimen. The evening before colonoscopy: dilute one bottle with water to a total volume of 16 ounces (up to the fill line) and drink the entire amount. Drink 32 ounces of water over the next hour. Next morning: repeat both steps using the second bottle. Complete preparation at least 2 hours before colonoscopy or as directed by physician. Oral medication administered within one hour of the start of each Suprep Bowel Prep Kit dose may be flushed from the gastrointestinal tract, and the medication may not be absorbed properly. Suprep may interact with medicines for blood pressure or heart problems, medicines for kidney problems, medicines for seizures, water pills (diuretics), nonsteroidal anti-inflammatory drugs (NSAIDs), and laxatives. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant before using Suprep Bowel Prep Kit. It is unknown if the components of Suprep Bowel Prep Kit passes into breast milk. Consult your doctor before breastfeeding.

Our Suprep Bowel Prep Kit (sodium sulfate, potassium sulfate, and magnesium sulfate) Oral SolutionSide Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Suprep Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • a headache and dizziness;
  • little or no urination;
  • severe nausea or vomiting;
  • painful bloating or stomach cramps;
  • trouble drinking liquids;
  • mouth sores;
  • a seizure;
  • irregular heartbeats; or
  • worsening gout symptoms (joint pain, redness, or swelling).

Common side effects may include:

  • stomach pain or discomfort;
  • nausea, vomiting; or
  • mild bloating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Suprep (sodium sulfate, potassium sulfate, and magnesium sulfate)

Suprep Professional Information

SIDE EFFECTS

Clinical Studies Experience

Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in clinical studies of another drug and may not reflect the rates observed in practice.

In a multicenter, controlled clinical trial comparing SUPREP Bowel Prep Kit with a bowel prep containing polyethylene glycol and electrolytes (PEG + E) that were administered in a split-dose (2-day) regimen, the most common adverse reactions after administration of SUPREP Bowel Prep Kit were overall discomfort, abdominal distention, abdominal pain, nausea, vomiting, and headache; see Table 1, below. Less common Adverse Reactions occurring were AV Block (1 case) and CK increase. In this study, patients receiving SUPREP Bowel Prep Kit were limited to a light breakfast followed by clear liquids; patients receiving the PEG + E bowel prep were allowed to have a normal breakfast and a light lunch, followed by clear liquids.

Table 1: Treatment-Emergent Adverse Reactions Observed in at Least 2% of Patients on the Split-Dose (2-Day) Regimen

Symptom Split-Dose (2-Day) Regimen
SUPREP
N=190
PEG + E product
N=189
Overall Discomfort 54% 67%
Abdominal Distension 40% 52%
Abdominal Pain 36% 43%
Nausea 36% 33%
Vomiting 8% 4%
Headache 1.1% 0.5%

Table 2 shows the percentages of patients who developed new abnormalities of important electrolytes and uric acid after completing the bowel preparation with either SUPREP Bowel Prep Kit or PEG+E administered as a split-dose (2-day) regimen.

Table 2: Patients with Normal Baseline Serum Chemistry with A Shift to an Abnormal Value While on the Split-Dose (2-Day) Regimen

    Day of Colonos copy
n (%)*
Day 30
n (%)*
Anion gap (high) † SUPREP 14 (8.9) 3 (1.9)
  PEG + Electrolytes 12 (7.6) 2 (1.4)
Bicarbonate (low) SUPREP 20 (12.7) 7 (4.4)
  PEG + Electrolytes 24 (15.2) 4 (2.7)
Bilirubin, total (high) SUPREP 14 (8.5) 0 (0)
  PEG + Electrolytes 20 (11.7) 3 (1.9)
BUN (high) SUPREP 2 (1.6) 14 (11.2)
  PEG + Electrolytes 4 (2.9) 19 (14.5)
Calcium (high) SUPREP 16 (10.4) 8 (5.2)
  PEG + Electrolytes 6 (3.7) 6 (3.9)
Chloride (high) SUPREP 4 (2.4) 6 (3.7)
  PEG + Electrolytes 20 (12.2) 6 (3.8)
Creatinine (high) SUPREP 3 (1.9) 5 (3.2)
  PEG + Electrolytes 2 (1.2) 8 (5.2)
Osmolality (high) SUPREP 8 (5.8) NA
  PEG + Electrolytes 19 (12.9) NA
Osmolality (low) SUPREP 3 (2.2) NA
  PEG + Electrolytes 2 (1.4) NA
Potassium (high) SUPREP 3 (1.8) 6 (3.7)
  PEG + Electrolytes 5 (2.9) 8 (4.9)
Sodium (low) SUPREP 5 (3.1) 1 (0.6)
  PEG + Electrolytes 4 (2.3) 2 (1.2)
Uric acid (high) SUPREP 27 (23.5) 13 (11.5)
  PEG + Electrolytes 12 (9.5) 20 (16.7)
*Percent (n/N) of patients where N=number of patients with normal baseline who had abnormal values at the timepoint(s) of interest.
†Patients with normal bicarbonate at baseline who developed low bicarbonate (≤ 21 mEq/L) and high anion gap (≥ 13 mEq/L) on Day of Colonoscopy or Day 30.

There were also 408 patients who participated in a study in which either SUPREP Bowel Prep Kit or PEG+E were administered in an evening-only (1-day) regimen. Higher rates of overall discomfort, abdominal distention, and nausea were observed with the evening-only (1-day) regimen compared to the split-dose (2-day) regimen for both preparations. Patients treated with SUPREP Bowel Prep Kit had increased rates of vomiting with the evening-only (1-day) regimen. An evening-only (1-day) dosing regimen was associated with higher rates of abnormal values for some electrolytes when compared to the split-dose (2-day) regimen for both preparations. For SUPREP Bowel Prep Kit, the evening-only (1- day) regimen was associated with higher rates of total bilirubin (high), BUN (high), creatinine (high), osmolality (high), potassium (high) and uric acid (high) than the SUPREP Bowel Prep Kit split-dose (2- day) regimen. Administration of SUPREP Bowel Prep Kit in an evening-only (1-day) dosing regimen is not recommended.

Read the entire FDA prescribing information for Suprep (sodium sulfate, potassium sulfate, and magnesium sulfate)

Related Resources for Suprep

© Suprep Patient Information is supplied by Cerner Multum, Inc. and Suprep Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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